女性骨和软组织肉瘤患者新辅助化疗期间早期卵巢储备耗竭：一项纵向抗苗勒管激素研究
Early Ovarian Reserve Depletion During Neoadjuvant Chemotherapy in Female Patients with Bone and Soft Tissue Sarcoma: A Longitudinal Anti-Müllerian Hormone Study.
摘要(中文译文)
骨与软组织肉瘤常累及儿童、青少年及年轻成人，然而该人群中化疗相关卵巢储备下降的数据仍然有限。本研究旨在描述治疗过程中抗苗勒管激素（AMH）的动态变化，并识别与新辅助化疗后（post-NACT）卵巢储备相关的因素。我们开展了一项回顾性、单中心、纵向队列研究，纳入85例在治疗期间接受连续血清AMH检测的女性骨与软组织肉瘤患者。在具有完整基线和NACT后AMH测量值的配对队列（n=75）中，NACT后AMH定义为完成NACT后手术/新辅助治疗时间点所获得的值。研究采用对数转换多变量线性模型及左删失Tobit回归敏感性分析。AMH中位数从基线的3.46 ng/mL下降至第一个NACT周期后的0.39 ng/mL，以及第二个周期后的0.15 ng/mL，分别对应88.7%和95.7%的降幅。在配对队列中，AMH中位数从3.81 ng/mL下降至NACT后的0.19 ng/mL，中位绝对降幅为2.75 ng/mL，中位百分比降幅为94.4%。在对数转换多变量线性模型中，log（基线AMH）是log（NACT后AMH）的唯一独立预测因子（β=0.735，95%CI 0.357-1.114，P<0.001）。在Tobit敏感性分析中，4个NACT后AMH值按0.05 ng/mL进行左删失处理，结果模式保持一致。女性肉瘤患者的卵巢储备耗竭主要发生在NACT的第一至第二个周期内。这些发现支持在该人群中早期开展个体化生育力保护咨询。
Abstract
: Bone and soft tissue sarcomas frequently affect children, adolescents, and young adults, yet data on chemotherapy-related ovarian reserve decline in this population remain limited. We aimed to characterize anti-Müllerian hormone (AMH) dynamics during treatment and identify factors associated with post-neoadjuvant chemotherapy (post-NACT) ovarian reserve. : We conducted a retrospective, single-center, longitudinal cohort study of 85 female patients with bone and soft tissue sarcoma who underwent serial serum AMH testing during treatment. In the paired cohort with complete baseline and post-NACT AMH measurements ( = 75), post-NACT AMH was defined as the value obtained at the surgery/post-neoadjuvant time point after completion of NACT. Log-transformed multivariable linear modeling and left-censored Tobit regression sensitivity analysis were performed. : Median AMH declined from 3.46 ng/mL at baseline to 0.39 ng/mL after the first NACT cycle and to 0.15 ng/mL after the second cycle, corresponding to reductions of 88.7% and 95.7%, respectively. In the paired cohort, median AMH declined from 3.81 ng/mL to 0.19 ng/mL post NACT, with a median absolute decline of 2.75 ng/mL and a median percent decline of 94.4%. In the log-transformed multivariable linear model, log(baseline AMH) was the sole independent predictor of log(post-NACT AMH) (β = 0.735, 95% CI 0.357-1.114, < 0.001). In Tobit sensitivity analysis, 4 post-NACT AMH values were treated as left-censored at 0.05 ng/mL, and the pattern remained consistent. : Ovarian reserve depletion in female sarcoma patients occurred predominantly within the first one to two cycles of NACT. These findings support early, individualized fertility preservation counseling in this population.
如何引用
AMA
Boyang Wang, Huimin Liu, Xiangyu Liu, Shidong Wang, Wei Guo, Jichuan Wang, et al. Early Ovarian Reserve Depletion During Neoadjuvant Chemotherapy in Female Patients with Bone and Soft Tissue Sarcoma: A Longitudinal Anti-Müllerian Hormone Study.. Cancers. 2026; doi:10.3390/cancers18111821.
APA
Boyang Wang, Huimin Liu, Xiangyu Liu, Shidong Wang, Wei Guo, Jichuan Wang, et al (2026). Early Ovarian Reserve Depletion During Neoadjuvant Chemotherapy in Female Patients with Bone and Soft Tissue Sarcoma: A Longitudinal Anti-Müllerian Hormone Study.. Cancers. https://doi.org/10.3390/cancers18111821
GB/T 7714
Boyang Wang, Huimin Liu, Xiangyu Liu, Shidong Wang, Wei Guo, Jichuan Wang, et al. Early Ovarian Reserve Depletion During Neoadjuvant Chemotherapy in Female Patients with Bone and Soft Tissue Sarcoma: A Longitudinal Anti-Müllerian Hormone Study.[J]. Cancers, 2026 doi:10.3390/cancers18111821.
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